Provider Demographics
NPI:1144464231
Name:WESTBURY CHIROPRACTIC INC PC
Entity type:Organization
Organization Name:WESTBURY CHIROPRACTIC INC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:WESTBURY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-708-1227
Mailing Address - Street 1:1441 TREMONT ST.
Mailing Address - Street 2:CHIROPRACTIC HEALTH CENTER
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02120
Mailing Address - Country:US
Mailing Address - Phone:617-708-1227
Mailing Address - Fax:617-708-1253
Practice Address - Street 1:1441 TREMONT ST.
Practice Address - Street 2:CHIROPRACTIC HEALTH CENTER
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02120
Practice Address - Country:US
Practice Address - Phone:617-708-1227
Practice Address - Fax:617-708-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty